Curing the queue

In this dissertation we study several problems related to the management of healthcare and the cure of disease. In each chapter a hospital capacity distribution problem is analyzed using techniques from operations research, also known as mathematical decision theory. The problems considered are inspired by logistical challenges faced by Leiden University Medical Center (LUMC). Several of the solutions we present in this dissertation have been implemented at LUMC.
Considering our aging population, shrinking workforce and the current hospital efficiency levels it will be difficult, if not impossible, to provide an appropriate level of care for the sick and the elderly in the coming decades. Given what is currently at stake, it is hard to understand that it is quite common in hospitals to avoid explicit decisions on resource allocation and capacity distribution and just anticipate on ad‐hoc basis on problems that occur. This is sometimes accompanied with very undesirable system outcomes such as patient cancellations and extremely long access (the time the patient spends on the waiting list) or waiting (the time the patient spends in the hospital waiting) times. The models we present allow for a quantification of consequences of capacity distribution decisions. The item that is distributed can either be time, or another kind of resource such as staffed beds. With the models a clear and succinct understanding of the problem, its possible solutions, and implications of these solutions can be obtained.
All models we present allow for a quantitative analysis of resource distribution problems in healthcare. We can conclude that mathematical modeling contributes to higher quality, more sound decision making in healthcare.